摘要
目的 探讨脑卒中高危患者的自我管理行为现状及其影响因素,为提高脑卒中高危患者自我管理行为提供依据.方法 采用便利抽样法,选取2023年3-6月在海军军医大学第一附属医院住院的395例脑卒中高危患者为研究对象,采用一般资料调查表、脑卒中高危患者自我管理行为评定量表及脑卒中知识问卷对患者进行调查,采用随机森林算法、多重线性回归分析探讨脑卒中高危患者自我管理行为的影响因素.本研究共发放395份问卷,剔除不合格问卷(规律性或重复性作答、前后选项矛盾等),最终回收有效问卷387份,问卷有效回收率为97.97％.结果 387例脑卒中高危患者自我管理行为评定量表得分为(137.60±25.47)分,得分指标为62.53％,处于中等水平,脑卒中知识问卷得分为(19.26±10.19)分.随机森林算法显示,影响因素重要性排序依次为脑卒中知识水平、获取健康信息途径数量、文化程度、危险因素个数、体检频率、医疗保险、年龄、工作情况及性别.Lasso回归结果显示误差最小时对应的影响因素为4个,将重要性排序前4名的因素纳入多重线性回归分析,结果显示,文化程度、危险因素个数、获取健康信息途径数量、脑卒中知识水平是脑卒中高危患者自我管理行为的影响因素(P＜0.05).结论 脑卒中高危患者自我管理行为处于中等水平,医务人员应该加大脑卒中相关知识宣教力度,针对不同的危险因素进行个性化宣教,提高目标人群自我管理水平,以降低脑卒中的发生.
Abstract
Objective To explore the status quo and influencing factors of self-management behavior in high-risk stroke patients,so as to provide a basis for improving their self-management behavior.Methods From March to June 2023,convenience sampling was used to select 395 high-risk stroke patients admitted to the First Affiliated Hospital of Naval Medical University as the study subject.A survey was conducted on patients using the General Information Questionnaire,Self-management Behavior Scale for High-risk Stroke Patients,and Cerebral Apoplexy Knowledge Questionnaire.Pearson correlation was used to analyze the correlation between self-management behavior and stroke knowledge.A total of 395 questionnaires were distributed,and unqualified questionnaires(such as regular or repetitive responses,conflicting options before and after)were excluded.Finally,387 valid questionnaires were collected,with an effective response rate of 97.97％.Results The score of the Self-management Behavior Scale for High-risk Stroke Patients for 387 high-risk stroke patients was(137.60±25.47),with a score indicator of 62.53％,which was at a moderate level.The score of the Cerebral Apoplexy Knowledge Questionnaire was(19.26±10.19),which was at a low level.The random forest algorithm showed that the importance order of influencing factors was stroke knowledge,number of ways to obtain health information,educational level,number of risk factors,frequency of physical examinations,medical insurance,age,work situation,and gender.The Lasso regression indicated that there were four influencing factors corresponding to the minimum error.The top four factors in importance were included in multiple linear regression,and the results showed that educational level,number of risk factors,number of ways to obtain health information,and stroke knowledge were the influencing factors of self-management behavior in high-risk stroke patients(P＜0.05).Conclusions The self-management behavior of high-risk stroke patients was at a moderate level.Medical and nursing staff should strengthen stroke knowledge education,provide personalized education for different risk factors,and improve the self-management of the target population to reduce the incidence of stroke.
基金项目
中国脑卒中高危患者干预适宜技术研究及推广项目(GN-2020R0004)
海军军医大学深蓝护理科研PI团队项目(2022KYP04)
NETL
NSTL
万方数据